LUMBAR DISC HERNIATION
Lumbar sponhdylosis is a degenerative disease of the spine and is related to aging in the disks that sit between the vertebral bodies. This condition is very common, with it's onset beginning as early as the late thirties. By ages 50 in men and 60 in women, the incidence may reach 90%. Initially the discs begin to dry out and the space between the vertebral bodies narrows. The ligaments supporting the spine begin to thicken and bone spurs form. The facet joints which help connect one vertebral body to the one below and above will also develop osteoarthritis. These processes are associated with inflammation and along with the bone spurs and thickened ligaments may result in the pinching of nerves as they exit the spinal column.
In certain cases, the degenerative disc may extrude into the spinal canal and cause direct pressure on the nerve root(s). This is called a "herniated disc". The problem may be aggravated or brought on by sprain or strain of the supporting structures (muscles, tendons, ligaments) of the lumbar spine, poor lifting techniques, obesity, or poor posture. Chronic emotional stress may play a role in the onset and severity of symptoms.
Initial evaluation will include examination and plain x-rays. Further evaluation with MRI, CT myelography, or nerve conduction studies may be indicated depending on responses to therapy. Your physician will decide if these tests are necessary.
Treatment may include anti-inflammatory medication, steroids, muscle relaxers, heat/ice therapy, and range of motion/strengthening exercises. Weight loss is indicated in those who are overweight. Patients who do not respond to these measures may be candidates for injection therapy, traction, Physical Therapy, or surgery. These symptoms may take days or weeks to resolve depending on the severity of any injury and your individual response to therapy. During treatment, avoid activities that aggravate pain such as prolonged sitting, standing, heavy lifting, or high impact/contact sports.
If you have been prescribed anti-inflammatory medications, please take the medication as directed. Continue the medication until you are able to do all of your regular activities without pain. Muscle relaxers and pain medications need only be taken as long as symptoms are moderate to severe and cause limitations in regular activities. You should not drive a motorized vehicle or operate heavy equipment while taking these medications.
You may be given a handout of low back exercises. Since exercise is so important to recovery, you should do these every day. Your Physician or Physician Assistant will guide you in how to progress through the exercise plan. It is generally recommended that you begin with the range of motion exercises for several days before beginning any strengthening exercises.
We recommend as a general guide to returning to your regular activities that include heavy lifting or high impact/contact sports, that your be able bend forward and backward fully and without pain. Your should be able to run, jump, and twist without pain and prolonged standing or sitting should not produce pain.
APPROACH TO EXERCISE
- Apply heat to the neck with a heating pad, hot shower, hot bath, or hot tub, for 10-15 minutes prior to beginning the range of motion, stretching exercise. Stretches should be to the point of feeling the muscle pull, not to the point of pain. Hold stretches for 5-8 counts and then relax, repeating 3 times.
- After adding any strengthening program, make sure to end the session with additional stretches. Pay close attention to form during your exercise program.
- If you have difficulty with the Home Exercise Program, formal Physical Therapy may be indicated. Feel free to ask your Doctor or Physician Assistant for a referral.
Request an appointment with our spine specialist Dr. Cubbage.
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